JFB Desktop Publishing

11550 S. Harlan Rd #30, Lathrop, CA, 95330-9730

Fax: 209) 983-0187, Voice (209) 983-0019

Pentax Order Form

Fill out this order form and print it. Mail or fax it to me
. Keep a copy for your records. We do not trust
the web with credit cards. There is always the possibility a talented hacker can
compromise you.

Name:

Address:

Ship to Above Address

Ship to Below Address

Ship To:

Payment Options:

Mail with Cashier's Check

Mail with Personal Check ( wait for check to
clear)

Pay by Credit Card

Credit Card:

Visa

MasterCard

American Express

Discover

Card number : Expiration
: Security code from back of card

Name on Credit Card:

Card Billing Address:

Home Phone with Area Code :

Day Phone with Area Code : Fax
Number:

E-mail :

DESCRIPTION

PRICE

QTY

TOTAL

$

$

$

$

$

Sub Total

$

Ca Residents add sales tax

Sales Tax

$

U.S .Shipping ( $7.50 / item up to a total of $30.00 for
small items) Printer Kits up to 7 pack sof paper or 6 rolld paper. $15.00
Cartoons of 36 rolls of paper $35.00 International $20.00 and up
Depending on weight and destination